Is there a Link between Human Herpes Virus Infection and Toll-like Receptors in the Pathogenesis of Pityriasis Rosea? A Case-control Study

Human herpesvirus (HHV) 6 and 7 are involved in the pathogenesis of pityriasis rosea (PR). Our aim was to evaluate the role of the innate immune response in PR through the detection of Toll-like receptors (TLR) 2, 3, 4, 7, 8, and 9 expression in the skin of affected patients and to detect the possibility of being induced by HHV-6 and/or HHV-7 viral coexistence in these patients. Twenty-four patients with PR and 24 healthy controls were included in this case-control study. Biopsy was obtained from the PR lesion and from the healthy skin of controls for detection of HHV-6 and 7 as well as TLRs 2, 3, 4, 7, 8, and 9 gene expression using real-time polymerase chain reaction (PCR). Significantly elevated expression of all studied TLRs and significantly higher viral load of HHV-6 and 7 in PR cases were detected. A significant higher expression of TLR2 and 4 in HHV-7 positive cases and a significant positive correlation between TLR9 and HHV-7 viral load were documented. HHV6 and 7 may also be involved in the pathogenesis of PR via TLR pathways  </p

Anti-Oxidant and Anti-Inflammatory Effects of Lipopolysaccharide from Rhodobacter sphaeroides against Ethanol-Induced Liver and Kidney Toxicity in Experimental Rats

This study aimed to investigate the protective effects of lipopolysaccharide from Rhodobacter sphaeroides (LPS-RS) against ethanol-induced hepatotoxicity and nephrotoxicity in experimental rats. The study involved an intact control group, LPS-RS group, two groups were given ethanol (3 and 5 g/kg/day) for 28 days, and two other groups (LPS-RS + 3 g/kg ethanol) and (LPS-RS + 5 g/kg ethanol) received a daily dose of LPS-RS (800 &mu;g/kg) before ethanol. Ethanol significantly increased the expression of nuclear factor kappa B (NF-&kappa;B) and levels of malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-&alpha;) and interleukin-6 (IL-6) in the liver tissue and decreased anti-oxidant enzymes. Hepcidin expression was downregulated in the liver, with increased serum levels of ferritin and iron. Prior-administration of LPS-RS alleviated the increase in oxidative stress and inflammatory markers, and preserved iron homeostasis markers. In the kidney, administration of ethanol caused significant increase in the expression of NF-&kappa;B and the levels of TNF-&alpha; and kidney injury markers; whereas LPS-RS + ethanol groups had significantly lower levels of those parameters. In conclusion; this study reports anti-oxidant, anti-inflammatory and iron homeostasis regulatory effects of the toll-like receptor 4 (TLR4) antagonist LPS-RS against ethanol induced toxicity in both the liver and the kidney of experimental rats

Subclinical synovitis and enthesitis in psoriasis patients and controls by ultrasonography in Saudi Arabia; incidence of psoriatic arthritis during two years

Objective: To evaluate ultrasonographic subclinical inflammatory synovitis and enthesitis in psoriasis patients, without clinical arthritis or enthesitis compared with healthy controls, with a 2-year follow-up to study the associated incidence of psoriatic arthritis (PsA). Methods: A total of 109 consecutive psoriasis vulgaris patients without clinical signs of PsA and 90 healthy controls were included from two tertiary medical centers. Subjects underwent dermatological examination, PASI score evaluation for severity of psoriasis, musculoskeletal examination using 68/66 joints count for tenderness and swollen joints. Patients were assessed for CRP, musculoskeletal ultrasound (MSUS) in the form of grayscale ultrasound (GSUS), and power Doppler ultrasound (PDUS) for eight entheses and 34 joints to detect MSUS subclinical enthesitis and synovitis. All patients were followed-up for 2 years to detect evolving PsA. Results: Subclinical enthesitis and synovitis were detected in 39.5% of psoriasis patients and 10% of controls (P < 0.001). CRP was significantly higher in psoriasis patients with MSUS manifestations (P < 0.01). PDUS and GSUS subclinical synovitis and/or enthesitis were detected at least in one site in psoriatic patients more than in controls (P < 0.05). During a 2-year follow-up of patients, the annual PsA incidence was 4.3%. Psoriasis patients who developed PsA showed a higher prevalence of baseline enthesitis, higher PDUS and GSUS synovitis scores, and higher baseline CRP level than those who did not develop PsA. Conclusions: MSUS subclinical synovitis and enthesitis are quite common in psoriasis patients. The incidence of PsA in Saudi’s psoriasis patients was slightly higher than worldwide reports. Subclinical enthesitis, PDUS, and GSUS synovitis could predict PsA development

Is there a Link between Human Herpes Virus Infection and Toll-like Receptors in the Pathogenesis of Pityriasis Rosea? A Case-control Study

Human herpesvirus (HHV) 6 and 7 are involved in the pathogenesis of pityriasis rosea (PR). Our aim was to evaluate the role of the innate immune response in PR through the detection of Toll-like receptors (TLR) 2, 3, 4, 7, 8, and 9 expression in the skin of affected patients and to detect the possibility of being induced by HHV-6 and/or HHV-7 viral coexistence in these patients. Twenty-four patients with PR and 24 healthy controls were included in this case-control study. Biopsy was obtained from the PR lesion and from the healthy skin of controls for detection of HHV-6 and 7 as well as TLRs 2, 3, 4, 7, 8, and 9 gene expression using real-time polymerase chain reaction (PCR). Significantly elevated expression of all studied TLRs and significantly higher viral load of HHV-6 and 7 in PR cases were detected. A significant higher expression of TLR2 and 4 in HHV-7 positive cases and a significant positive correlation between TLR9 and HHV-7 viral load were documented. HHV6 and 7 may also be involved in the pathogenesis of PR via TLR pathways  </p

Comparison between CURB-65, PSI, and SIPF scores as predictors of ICU admission and mortality in community-acquired pneumonia

Objective: To compare the prognostic value of the SIPF (shock index and hypoxemia) score as the combination of shock index (heart rate/systolic blood pressure) >0.7 (1 point) plus PaO2/FiO2 < 250 (1 point), and the severity score for community-acquired pneumonia (CAP) (CURB-65) and pneumonia severity index (PSI) in predicting the need for ICU admission and mortality of patients with community-acquired pneumonia. Patients and methods: This retrospective study was conducted on patients with CAP admitted to AL-Hussein University hospital (Egypt), Muhayl general hospital and King Khalid hospital at Hail, (KSA). The information required for calculating SIPF, PSI and CURB-65 was extracted from the medical records. Results: We studied 100 patients with community-acquired pneumonia (64 men, 36 women). Thirty-four patients needed ICU admission (while 66 did not need ICU admission and admitted in observation room or general ward) and among the ICU patients 21 cases needed mechanical ventilation. Ten cases died; 9 cases in ICU and one case in observation room (ward). The ability to predict ICU admission was higher for SIPF score compared to CURB-65 (AUC SIPF 0.88 vs. 0.83; p < 0.001) and PSI (AUC SIPF 0.88 vs. 0.79; p < 0.001). The ability to predict mortality was higher for SIPF score compared to CURB-65(AUC SIPF 0.80 vs. 0.84; p < 0.001) and PSI (AUC SIPF 0.80 vs. 0.83; p < 0.001). Conclusion: The ability of SIPF score to predict ICU admission in CAP is higher than that of CURB-65 and PSI. Simple SIPF score could be a useful tool to predict mortality in CAP